of nurse anesthesia programs practice...
TRANSCRIPT
STANDARDS FOR ACCREDITATION
OF NURSE ANESTHESIA PROGRAMS
Practice Doctorate
Approved by the Council on Accreditation of
Nurse Anesthesia Educational Programs
October 12, 2012
Draft 1 (Revised)
Copyright © 2012 by the Council on Accreditation of Nurse Anesthesia Educational Programs
222 S Prospect Avenue – Suite 304 Park Ridge, Illinois, 60068-4001
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 2
Introduction
The accreditation standards for nurse anesthesia programs at the practice doctorate level are
written with input from a wide community of interest including many individuals and groups
that are affected by them, including certified registered nurse anesthetist (CRNA) practitioners
and educators; nurse anesthesia students; administrators and faculty of colleges and
universities; hospital administrators; state boards of nursing; the staff of the U.S. Department
of Education (USDE); the Council for Higher Education Accreditation (CHEA), and other
nationally recognized accreditation agencies; members of the National Board of Certification
and Recertification of Nurse Anesthetists; and the Board of Directors of the American
Association of Nurse Anesthetists (AANA). Special recognition is given to members of the
Assembly of School Faculty of Nurse Anesthesia and to those on the AANA Education
Committee for their continuing efforts to promote, support, and encourage the Council on
Accreditation of Nurse Anesthesia Educational Program's (Council) objectives of quality
assessment and enhancement in nurse anesthesia education through the accreditation
process.
The standards are designed to prepare graduates for entry into practice. Entry into practice is
defined as:
Entry into practice competencies for the nurse anesthesia professional prepared at the
practice doctoral level are those required at the time of graduation to provide safe,
competent, and ethical anesthesia and anesthesia-related care to patients for
diagnostic, therapeutic, and surgical procedures.
Entry into practice competencies should be viewed as the structure upon which nurse
anesthetists continue to acquire knowledge, skills, and abilities along the practice
continuum that starts at graduation (proficient), and continues throughout their entire
professional careers (expert).
Suggestions for future revisions should be forwarded to:
Council on Accreditation of Nurse Anesthesia Educational Programs
222 South Prospect Avenue, Suite 304
Park Ridge, Illinois 60068-4001
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 3
The Value of Accreditation
Accreditation is an activity that has long been accepted in the United States, but may not be as
well known in most other countries because they rely on governmental supervision and control
of educational institutions. The accomplishments and outstanding successes in the education of
Americans can be traced in large part to the past reluctance of the United States to impose
governmental restrictions on institutions of postsecondary education and to the success of the
voluntary American system of accreditation in promoting quality without inhibiting innovation.
Accreditation is a voluntary activity that has been accepted for more than 100 years in the U.S.
in contrast to other countries where governments supervise and control educational
institutions. The goals of privately operated U.S. accrediting agencies are to assure and improve
the quality of education offered by the institutions and programs they accredit. In this system,
accreditation by an accrediting agency that is recognized by the U.S. Secretary of Education, is
necessary for institutions and programs to receive federal funds and for students to receive
federal aid. Accrediting agencies recognized by federal and state governments are deemed
reliable authorities of academic quality.
The large percentage of Americans who benefit from higher education, the reputation of U.S.
universities for both fundamental and applied research, and the widespread availability of
professional services in the United States, all attest to the high quality of postsecondary
education and the success of the accreditation system that the U.S. institutions and professions
have devised to promote quality.
Accreditation is a peer process whereby a private, nongovernmental agency grants public
recognition to an institution or specialized program that meets or exceeds nationally
established standards of acceptable educational quality. A guiding principle of accreditation is
the recognition that institutions or specialized programs have a right to expect that they will be
evaluated in the light of their own stated purposes, as long as those purposes are educationally
appropriate, meet accreditation standards, and fall within the recognized scope of the
accrediting body.
There are two fundamental reasons for accreditation: (1) to ensure quality assessment and (2)
to assist in quality improvement. Accreditation, which applies to institutions or programs, must
be distinguished from certification and licensure, which apply to individuals. Accreditation
cannot guarantee the quality of individual graduates, but it can provide reasonable assurance
of the context and quality of the education that is offered.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 4
Accreditation provides services that are of value to several constituencies:
The public receives:
1) reasonable assurance of the external evaluation of a program and its conformity with general
expectations in the professional field;
2) identification of programs that have voluntarily undertaken explicit activities directed at
improving their quality and their successful execution;
3) improvement in the professional services available to the public, resulting from the
modification of program requirements to reflect changes in knowledge and practice that are
generally accepted in the field;
4) less need for intervention by public agencies in the operations of educational programs,
because of the availability of private accreditation for the maintenance and enhancement of
educational quality.
Students benefit from:
1) reasonable assurance that the educational activities of an accredited program have been
found to be satisfactory and meet the needs of students;
2) assistance in transferring credits among programs and institutions;
3) a uniform prerequisite for entering the profession.
Programs receive:
1) the stimulus needed for self-directed improvement;
2) peer review and counsel provided by the accrediting agency;
3) enhancement of their reputation, because of the public’s regard for accreditation;
4) eligibility for selected governmental funding programs and private foundation grants.
The profession realizes:
1) a means for participation of practitioners in establishing the requirements for preparation to
enter the profession;
2) a contribution to the unity of the profession by bringing together practitioners, educators,
students, and the communities of interest in an activity directed toward improving
professional preparation and practice.
References:
• The Value of Accreditation, Council for Higher Education Accreditation, 2010.
• The Importance of Specialized Accreditation: A Message to Our Publics, ASPA, 2007.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 5
The Accreditation Process
The Council on Accreditation is responsible for establishing the standards for accreditation of
nurse anesthesia educational programs, subject to consideration of the revisions by the
communities of interest. The practice doctorate standards address: (A) conducting institutions,
(B) faculty, (C) students, (D) graduates, (E) curriculum, (F) clinical sites, (G) policies, and (H)
evaluation. In an effort of ongoing improvement, the standards will undergo continual review
and be subject to periodic major and minor revisions as indicated. Compliance with the
standards forms the basis for the Council’s accreditation decisions.
Certain criteria have been ascertained to have major significance regarding educational quality.
Failure to fully comply with one or more of these criteria is considered to be of critical concern
in decisions regarding nurse anesthesia program accreditation and is marked with an asterisk
(*). The Council reserves the right to identify other areas or criteria. The accreditation process
for established programs is based on the self-evaluation study document prepared by the
program and on an on-site review by a team of two or three reviewers. The process is repeated
at intervals up to 10 years. A summary report of the review is presented to the Council for an
accreditation decision. New programs that seek accreditation status must successfully complete
an initial accreditation review, admit students and undergo a subsequent review after the first
students graduate when it is possible to evaluate educational outcomes following the first
graduation.
Ongoing oversight by the Council is provided between formal programmatic reviews. Programs
are required to advise the Council and get approval for major changes. The Council also
investigates situations brought to its attention that may affect a program's accreditation status.
Each program is required to complete and submit an annual report.
In a broad sense, accreditation of nurse anesthesia educational programs provides quality
assurance concerning educational preparation through continuous self-study and review. The
ultimate goals of the accreditation program are to improve the quality of nurse anesthesia
education and provide competent nurse anesthetists for healthcare consumers and employers.
Graduation from an accredited program is a prerequisite for eligibility for national certification,
and it is also used as a criterion by licensing agencies, employers, and potential students in the
decisions they make and in determining eligibility for government funding.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 6
A. CONDUCTING INSTITUTION STANDARDS
1. The mission and/or philosophy of the conducting institution's governing body
promote(s) educational excellence and supports the nurse anesthesia program within
a doctoral framework.
* 2. The degree granting institution is accredited by a regional or national accrediting
agency. The accrediting agency must be officially recognized by the U.S. Secretary of
Education to accredit institutions (see Glossary “Institutional Accreditor”).
3. The organizational relationships of the institution, academic unit, and program are
clearly delineated.
* 4. The conducting organization completes a legally binding written agreement that
outlines the expectations and responsibilities of all parties when an academic
affiliation is established or two or more entities with unshared governance enter
into a joint arrangement to conduct a program (see Glossary "Unshared
Governance").
5. The amount of advanced standing or transfer credit awarded by the degree granting
institution is clearly stated and publicized.
6. The governance structure(s) facilitates effective communication.
7. The CRNA program administrator, or an individual designated by the CRNA program
administrator, participates in institutional planning, curriculum design and review,
and other appropriate governance roles.
8. The institution’s and/or program’s committee structure is appropriate to meet
program objectives, and includes public, student and faculty participation (see
Glossary “Public Member”).
* 9. The conducting institution provides sufficient time to permit faculty to fulfill their
obligations to students including clinical and classroom teaching, counseling and
evaluation, and advising on doctoral level scholarly activities.
10. The conducting institution provides sufficient protected time to permit faculty to
fulfill their own scholarly activities, service, administrative, and clinical
responsibilities (see Glossary "Protected Time").
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 7
* 11. The program’s resources must be adequate to support the scale and scope of the
operation and the total number of students to promote the quality of graduates so
they can graduate appropriately prepared for entry into practice, including:
11. 1. financial resources that are budgeted and used to meet accreditation
standards.
11. 2. physical resources including facilities, equipment, and supplies.
11. 3. learning resources including clinical sites, library, and technological access and
support.
11. 4. faculty.
11. 5. support personnel.
11. 6. student services (see Glossary "Student Services").
* 12. The program seeks Council approval prior to increasing class size and demonstrates
reasonable assurance that there are adequate resources as delineated in Standard
A.11..
* 13. The program is required to act in accordance with the Council's Accreditation Policies
and Procedures.
14. There is evidence that eligibility and certification requirements are maintained by
institutions or programs relying on Council’s accreditation to participate in Higher
Education Opportunity Act, Title IV programs (see Glossary "Title IV Eligibility").
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 8
B. FACULTY STANDARDS
CRNA Program Administrator:
* 1. The program is administered by a doctorally prepared CRNA who has the
leadership authority and accountability for program administration.1
2. The CRNA program administrator’s doctoral degree must be from an accredited
institution of higher education that was accredited by an agency officially
recognized by the U.S. Secretary of Education to accredit institutions, at the time
the degree was conferred. The accrediting agency must be officially recognized
by the U.S. Secretary of Education to accredit institutions (see Glossary
“Institutional Accreditor”).
3. The CRNA program administrator must be experientially qualified to provide
leadership to the program (see Glossary “Experientially Qualified”).
4. The CRNA program administrator is full time (see Glossary "Full Time Program
Administrator").
* 5. The CRNA program administrator has a current unencumbered license or privilege
to practice as a registered professional nurse and/or APRN in the state or territory
of jurisdiction of the program (see Glossary "Privilege to Practice").2
∗ 6. The CRNA program administrator has current certification or current
recertification by the National Board of Certification and Recertification for
Nurse Anesthetists (NBCRNA).
7. The CRNA program administrator has the authority to prepare and administer
the program budget.
8. The CRNA program administrator demonstrates knowledge of environmental
issues that may influence the program and nurse anesthesia practice by
engaging in professional development.
1 Doctoral degrees are required for the CRNA program administrators (program administrator and assistant program
administrator) in all doctoral programs by 2018.
2 A federal government/military nurse practicing exclusively in federal or military systems only needs one license
from any state or territory per U.S. federal government/military policy.
∗
Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 9
Assistant CRNA Program Administrator:
* 9. The assistant CRNA program administrator is a doctorally prepared CRNA who is
experientially qualified to assist the CRNA program administrator and, if required,
assume leadership responsibilities for the program (see Glossary “Experientially
Qualified”).3
10. The assistant CRNA program administrator’s doctoral degree must be from an
accredited institution of higher education that was accredited by an agency
officially recognized by the U.S. Secretary of Education to accredit institutions, at
the time the degree was conferred. The accrediting agency must be officially
recognized by the U.S. Secretary of Education to accredit institutions (see
Glossary “Institutional Accreditor”).
* 11. The assistant CRNA program administrator has a current unencumbered license or
privilege to practice as a registered professional nurse and/or APRN in the state or
territory of jurisdiction of the program.2
* 12. The assistant CRNA program administrator has current certification or current
recertification by the NBCRNA.
13. The assistant CRNA program administrator demonstrates knowledge of
environmental issues that may influence the program and nurse anesthesia
practice by engaging in professional development.
CRNA Faculty:
14. Didactic faculty meet the governing body’s requirements for teaching doctoral
level courses.
* 15. CRNA faculty have a current unencumbered license or privilege to practice as a
registered professional nurse and/or APRN in compliance with state law. in the
state or territory of jurisdiction of the program. 2
* 16. CRNA faculty have current certification or current recertification by the NBCRNA.
3 Doctoral degrees are required for the CRNA program administrators (program administrator and assistant program
administrator) in all doctoral programs by 2018.
2 A federal government/military nurse practicing exclusively in federal or military systems only needs one license
from any state or territory per U.S. federal government/military policy.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 10
17. Core CRNA program faculty, including the program administrator, assistant
program administrator, and course directors, have formal instruction in
curriculum, evaluation and instruction (see Glossary, “Formal Instruction in
Curriculum, Evaluation and Instruction”).
18. CRNA faculty who teach clinical anesthesia content must demonstrate clinical
competency (see Glossary "Demonstration of Clinical Competency").
19. Only CRNA and anesthesiologist faculty may teach clinical anesthesia content.
Non-CRNA Faculty:
20. Non-CRNA faculty must be academically prepared for the areas in which they
teach (see Glossary "Academic Preparation").
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 11
C. STUDENT STANDARDS
Selection and Admissions:
1. The program enrolls only students who by academic and experiential achievement
are of the quality appropriate for the profession and who have the ability to benefit
from their education.
*
2. Admission requirements include:
2. 1. A baccalaureate or graduate degree in nursing or an appropriate major.
2. 2. An unencumbered license as a registered professional nurse and/or an
APRN in the United States or its territories, or protectorates.
2. 3. A minimum of one year full time work experience, or its part time
equivalent, as a RN in a critical care setting. The applicant must have
developed as an independent decision-maker capable of using and
interpreting advanced monitoring techniques based on knowledge of
physiological and pharmacological principles (see Glossary "Critical Care
Experience").
2. 4. Current certification in advanced cardiac life support (ACLS) and pediatric
advanced life support (PALS).
Student Participation and Conduct:
3. Students demonstrate professionalism, including a commitment to academic and
personal integrity.
4. Students keep accurate and complete clinical experience logs that are reviewed by
program faculty on a regular basis (see Glossary "Counting Clinical Experiences").
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 12
D. GRADUATE STANDARDS
The graduate must demonstrate the ability to:
Patient Safety:
* 1. Be vigilant in the delivery of patient care.
* 2. Refrain from engaging in extraneous activities that abandon or minimize vigilance
while providing direct patient care (e.g., texting, reading, e-mailing, etc.).
* 3. Conduct a comprehensive equipment check.
* 4. Protect patients from iatrogenic complications.
Perianesthesia:
* 5. Provide individualized care throughout the perianesthesia continuum.
* 6. Deliver culturally competent perianesthesia care (see Glossary “Culturally
Competent”).
* 7. Provide anesthesia services to all patients across the lifespan (see Glossary
"Anesthesia Services" and “Across the Lifespan”).
8. Perform a comprehensive history and physical assessment.
* 98. Administer and manage general anesthesia to patients with a variety of physical
conditions.
* 109. Administer and manage general anesthesia for a variety of surgical and medically
related procedures.
* 110. Administer and manage a variety of regional anesthetics.
* 121. Maintain current certification in ACLS and PALS.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 13
Critical Thinking:
* 132. Apply knowledge to practice in decision–making and problem solving.
* 143. Provide nurse anesthesia services based on evidence based principles.
* 154. Perform a preanesthetic assessment prior to providing anesthesia services.
* 165. Assume responsibility and accountability for diagnosis.
* 176. Formulate an anesthesia plan of care prior to providing anesthesia services.
* 187. Identify and take appropriate action when confronted with anesthetic
equipment-related malfunctions.
* 198. Interpret and utilize data obtained from noninvasive and invasive monitoring
modalities.
* 2019. Calculate, initiate, and manage fluid and blood component therapy.
* 210. Recognize, evaluate, and manage the physiological responses coincident to the
provision of anesthesia services.
* 221. Recognize and appropriately manage complications that occur during the
provision of anesthesia services.
* 232. Use science-based theories and concepts to analyze new practice approaches.
Pass the national certification examination (NCE) administered by NBCRNA.
* 243. Pass the national certification examination (NCE) administered by NBCRNA.
Use science-based theories and concepts to analyze new practice approaches.
Communication:
* 254. Utilize interpersonal and communication skills that result in the effective
exchange of information and collaboration with patients and their families.
* 265. Utilize interpersonal and communication skills that result in the effective
interprofessional exchange of information and collaboration with other
healthcare professionals.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 14
* 276. Respect the dignity and privacy of patients while maintaining confidentiality in
the delivery of interprofessional care.
* 287. Maintain comprehensive, timely, accurate, and legible healthcare records.
* 298. Transfer the responsibility for care of the patient to other qualified providers in a
manner that assures continuity of care and patient safety.
* 3029. Teach others.
Leadership:
* 3130. Integrate critical and reflective thinking in his or her leadership approach.
* 321. Provide leadership that facilitates intraprofessional and interprofessional
collaboration.
Professional Role:
* 332. Understand the personal obligation to adhere to the Code of Ethics for the CRNA.
* 343. Interact on a professional level with integrity.
* 354. Apply ethically sound decision-making processes.
* 365. Function within legal and regulatory requirements.
* 376. Accept responsibility and accountability for his or her practice.
* 387. Provide anesthesia services to patients in a cost-effective manner. anesthesia
services to patients.
**
398. Accept responsibility and accountability to appear for duty appropriately rested
and fit to provide the services required by patients.
4039. Demonstrate knowledge of wellness and chemical dependency in the anesthesia
profession through completion of content in wellness and chemical dependency
(see Glossary "Chemical Dependency and Wellness").
* 410. Inform the public of the role and practice of the CRNA.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 15
* 421. Evaluate how public policy making strategies impact the financing and delivery of
healthcare.
* 432. Advocate for health policy change to improve patient care.
* 443. Advocate for health policy change to advance the specialty of nurse anesthesia.
* 454. Analyze strategies to improve patient outcomes and quality of care.
* 465. Analyze health outcomes in a variety of populations.
* 476. Analyze health outcomes in a variety of clinical settings.
* 487. Analyze health outcomes in a variety of systems.
* 498. Disseminate research evidence.
* 5049. Use information systems/technology to support and improve patient care.
* 510. Use information systems/technology to support and improve healthcare systems.
* 521. Analyze business practices encountered in nurse anesthesia delivery settings.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 16
E. CURRICULUM STANDARDS
* 1. The curriculum is designed to award a Doctor of Nursing Practice or Doctor of Nurse
Anesthesia Practice to graduate students who successfully complete graduation
requirements.
* 2. The curriculum is designed to focus on the full scope of nurse anesthesia practice
including:
2. 1. Course(s): Advanced Physiology/Pathophysiology (120 contact hours),
Advanced Pharmacology (90 contact hours), Basic and Advanced Principles in
Nurse Anesthesia (120 contact hours), and Advanced Health Assessment (see
Glossary “Advanced Health Assessment”).
2. 2. Content: Advanced Physiology/Pathophysiology (120 contact hours),
advanced pharmacology (90 contact hours), basic and advanced principles in
nurse anesthesia (120 contact hours),research (75 contact hours), advanced
health assessment (45 contact hours), human anatomy, chemistry,
biochemistry, physics, genetics, acute and chronic pain management,
radiology, ultrasound, anesthesia equipment, professional role
development, chemical dependency and wellness, informatics, ethical and
multicultural healthcare, leadership and management, business of
anesthesia/practice management, health policy, healthcare finance,
integration/clinical correlation (see Glossary, “Chemical Dependency and
Wellness,” “Pain Management-Acute,” “Pain Management-Chronic,”
"Professional Role Development," and “Radiology”).
2. 3. Clinical experiences (see Appendix).
3. The curriculum meets commonly accepted national standards for similar degrees
(see Glossary “Commonly Accepted National Standards”).
4. The post-baccalaureate curriculum is a minimum of 3 years of full-time study or
longer if there are periods of part-time study.4
4 Shorter programs of study can be submitted for consideration when accompanied by supporting rationale that
ensures compliance with accreditation standards.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 17
5. The curriculum is composed of sequential and integrated courses designed to
facilitate achievement of the program’s terminal objectives.
6. All courses have clearly stated objectives.
7. Distance education programs and courses satisfy accreditation standards and
achieve the same outcomes as traditional educational offerings.
8. The curriculum requires the student to complete scholarly work that demonstrates
knowledge and scholarship skills within the area of academic focus (see Glossary
"Scholarly Work").
9. The clinical curriculum provides students with experiences in the perioperative
process that are unrestricted, and promote their development as competent nurse
anesthetists.
10. The program provides opportunities for students to obtain clinical experiences
outside the regular clinical schedule by a call experience or other mechanism (see
Glossary "Call Experience").
11. Simulated clinical experiences are incorporated in the curriculum (see Glossary
“Simulated Clinical Experience”).
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 18
F. CLINICAL SITE STANDARDS
* 1. The program demonstrates it has sufficient clinical resources to assure
graduates individually meet all accreditation requirements.
2. The program has a legally binding contract with the clinical site(s) that outlines
expectations and responsibilities of both parties.
3. The program identifies a CRNA coordinator for each clinical site who possesses
a master’s degree (doctoral preparation preferred) to guide student learning.
An anesthesiologist may serve in this capacity.5
4. The program demonstrates that the educational environment at all clinical sites
is conducive to student learning.
* 5. Supervision at clinical sites is limited to CRNAs and anesthesiologists who are
institutionally credentialed to practice and immediately available for
consultation. Instruction by graduate registered nurse anesthetists or physician
residents is never appropriate.
6. Clinical site orientations are provided that outline role expectations and
responsibilities of students and identify available learning resources.
* 7. The clinical supervision ratio of students to instructor insures patient safety by
taking into consideration: the complexity of the anesthetic and/or surgical
procedure, the student’s knowledge and ability, and the co-morbidities
associated with the patient. At no time does the number of students directly
supervised by an individual clinical instructor exceed 2:1 (see Glossary “Clinical
Supervision”).
8. The program restricts clinical supervision in nonanesthetizing areas to
credentialed experts who are authorized to assume responsibility for the student
(see Glossary “Credentialed Expert”).
* 9. Student time commitment should consists of a reasonable number of hours
that does not exceed 64 hours per week (see Glossary "Reasonable Time
Commitment").
5 A process for submitting a waiver for the requirement of a coordinator with a master’s degree under some
circumstances is currently under development.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 19
G. POLICY STANDARDS
1. Accurate cumulative records of educational activities are maintained.
* 2. Truth and accuracy are evidenced in recruiting and admissions practices, academic
calendars, catalogs, publications, grading, and advertising.
* 3. The following are published annually:
3. 1. accurate information about the nurse anesthesia program’s programmatic
accreditation status.
3. 2. the specific academic program covered by the accreditation status.
3. 3. the name, address, telephone number and URL (http://home.coa.us.com) of
the Council on Accreditation of Nurse Anesthesia Educational Programs .
3. 4. for the most recent graduating class, the:
3.4.1. attrition.
3.4.2. employment of graduates within six months of graduation.
3.4.3. NBCRNA NCE pass rate for first time takers (see Glossary "Published
Outcomes").
4. Policies and procedures that are fair, equitable, and do not discriminate are defined
(see Glossary "Nondiscriminatory Practice").
5. Policies and procedures regarding academic integrity are defined and used in all
educational activities.
6. Policies outline the procedures for student discipline and dismissal.
7. The program demonstrates that it processes complaints, grievances, and appeals in
a timely and equitable manner affording adequate due process.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 20
* 8. The program forbids the employment of nurse anesthesia students as nurse
anesthetists by title or function.
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 21
H. EVALUATION STANDARDS
1. The program has a written systematic plan for continuous self-assessment that
incorporates the following:
* 1.1. Formative and summative evaluations of each student that are conducted for
the purpose of counseling students and documenting student achievement.
1.1.1. Terminal evaluation is completed to demonstrate student achievement
of Graduate Standards D1-D52.
1.1.2. There is an established assessment procedure to verify competence in
pertinent scholarship skills relevant to the area of academic focus.
* 1.2. Students evaluate the quality of:
1.2.1. courses
1.2.2. didactic instruction
1.2.3. clinical sites
1.2.4. clinical instruction
1.2.5. teaching and learning environment
1.2.6. their own achievement (self-evaluation)
1.2.7. program
1.2.7.1. institutional/program resources
1.2.7.2. student services (see Glossary “Student Services”)
1.2.7.3. curriculum
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 22
1.3. Faculty evaluate the quality of:
1.3.1. faculty services
1.3.2. the program
1.3.3. their own contributions to teaching, practice, service, and scholarly
activities (self-evaluation)
1.4. Alumni evaluate:
1.4.1. the quality of the program
1.4.2. their preparation to enter anesthesia practice (self-evaluation)
1.4.3. their involvement in professional activities (self-evaluation)
1.5. Employers evaluate the:
1.5.1. competence of graduates entering anesthesia practice
1.5.2. performance of recent graduates
* 1.6. Outcome measures of academic quality including:
1.6.1. student attrition
1.6.2. NBCRNA NCE pass rates and mean scores
1.6.3. employment rates
1.6.4. any other outcome methods of student achievement identified by the
program and/or institution (see Glossary “Academic Quality”).
* 2. The program utilizes evaluation data (including that from the systematic plan for
continuous self-assessment) to:
2.1. monitor and improve program quality and effectiveness
2.2. monitor and improve student achievement
* Failure to fully comply with one or more of these criteria is considered to be of critical concern in decisions
regarding nurse anesthesia program accreditation.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 23
2.3. monitor compliance with accreditation requirements and initiate corrective action
should areas of noncompliance occur.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 24
Appendix
The minimum number of clinical hours is 1200 (1600 preferred).
CLINICAL EXPERIENCES
Minimum
Required
Cases
Preferred
Number of
Cases
PATIENT PHYSICAL STATUS
Class I
Class II
Classes III –VI & IV 200 100 300 0
Class III 50 100
Class IV 10 100
Class V 0 2 0 5
Class VI
TOTAL CASES 650 550 750 650
SPECIAL CASES
Geriatric 65 + years 100 50 200 100
Pediatric
Pediatric 2 to 12 years 30 25 75
Pediatric (less than 2 years) 10 25
Neonate (less than 4 weeks) 5
Trauma/Emergency (E) 30 50
Obstetrical management 40 30 50 40
Cesarean delivery 15 10 20 15
Analgesia for labor 15 10 20 15
Pain Management Encounters (see Glossary, “Pain Management
Encounters”) (new)
15 50
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 25
CLINICAL EXPERIENCES
Minimum
Required
Cases
Preferred
Number of
Cases
ANATOMICAL CATEGORIES 6
Intra-abdominal 75
Intracranial7 5 20
Oropharyngeal 20
Intrathoracic 15 40
Heart 5 10
Lung 5
Neck 5 10
Neuroskeletal 20
Vascular 20 10 30 20
6 Count all that apply
7 A majority of these cases must be open.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 26
CLINICAL EXPERIENCES
Minimum
Required
Cases
Preferred
Number of
Cases
METHODS OF ANESTHESIA
General anesthesia 450 350
Induction, maintenance, and emergence
Inhalation induction 25 10 40 25
Mask management 30 25 40
Supraglottic airway devices (previously Laryngeal mask
airways)
35 25 50
Tracheal intubation
a. Oral 300 200
b. Nasal 50 10
Emergence from anesthesia 300 200
Regional techniques
Management 30 50
1. anesthesia
2. pain management
Administration (total of a, b & c) 35 25
a. Spinal 10 1 50
1. anesthesia
2. pain management
b. Epidural 10 1 50
1. anesthesia
2. pain management
c. Peripheral 5 1 40
1. anesthesia
2. pain management
Monitored anesthesia care Moderate/deep sedation 25
50
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 27
CLINICAL EXPERIENCES
Minimum
Required
Cases
Preferred
Number of
Cases
ARTERIAL TECHNIQUE
Arterial puncture/catheter insertion 25
Intra-arterial BP monitoring 30 25
CENTRAL VENOUS PRESSURE CATHETER
Placement 8 (total of a & b) 10 5 15 10
a. Actual
b. Simulated
Monitoring 15
PULMONARY ARTERY CATHETER
Placement 5
Monitoring 10
OTHER
Intravenous catheter placement 150 100
Alternative airway management techniques (total of 1 & 2)
(see Glossary: alternative airway management techniques)
25 10 50 40
1) Fiberoptic Endoscopic techniques8
(total of a, b & c) 5 15
a) Actual placement
b) Simulated placement
c) Airway assessment
2) Other techniques 5 25
8 Simple models and simulated experiences may be used to satisfy part of this requirement. No clinical experiences
can be obtained by simulation alone.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 28
Glossary
Academic Preparation – Academic preparation includes degree specialization, specialty course
work, and other preparation to address the major concepts included in the courses taught.
Academic Quality – Academic quality refers to results associated with teaching, learning,
research, and service within the framework of the institutional mission. Academic quality
requires an effective learning environment and sufficient resources for faculty and students to
obtain the objectives of the program and meet accreditation standards.
Across the Lifespan – Across the lifespan refers to a patient population-focus of families and
individuals. The continuum of care ranges from the prenatal period to end of life with health
statuses ranging from healthy through all levels of acuity, including immediate, severe, or life-
threatening illnesses or injury.
Advanced Health Assessment – A course in advanced health assessment includes assessment
of all human systems, advanced assessment techniques, diagnosis, concepts, and approaches.
Anesthesia Services – Anesthesia and anesthesia-related care represent those services which
anesthesia professionals provide upon request, assignment and referral by the patient’s
healthcare provider authorized by law, most often to facilitate diagnostic, therapeutic and
surgical procedures. In other instances, the referral or request for consultation or assistance
may be for management of pain associated with obstetrical labor and delivery, management of
acute and chronic mechanical ventilation, or management of acute and chronic pain through
the performance of selected diagnostic and therapeutic blocks or other forms of pain
management.
Call Experience – Call is a planned clinical experience outside the normal operating hours of the
clinical facility, for example, after 5 p.m. and before 7 a.m., Monday through Friday, and on
weekends. Assigned duty on shifts falling within these hours is considered the equivalent of an
anesthesia call, during which a student is afforded the opportunity to gain experience with
emergency cases. Although a student may be assigned to a 24 hour call experience, at no time
may a student provide direct patient care for a period longer than 16 continuous hours.
Chemical Dependency and Wellness – Chemical dependency includes substance related
disorders characterized by chronicity and progression that threaten wellness. Wellness is
defined as a positive state of the mind, body, and spirit reflecting a balance of effective
adaptation, resilience, and coping mechanisms in personal and professional environments that
enhance quality of life. The wellness/chemical dependency curriculum must be an evidence-
based program of study which could include but is not limited to the following five key
conceptual components:
1. Importance of Wellness to Health Care Professionals: Describe the integration of healthy
lifestyles, adaptive coping mechanisms for career stressors, and an awareness of
chemical dependency risk factors and pathophysiology.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 29
2. Healthy Lifestyles: Describe attitudes, behaviors, and strategies (i.e., healthy nutrition,
exercise, sleep patterns, and critical incidents’ stress management) that create a
positive balance between one’s personal and professional life for personal wellness.
3. Coping Mechanisms: Describe adaptive or maladaptive strategies and/or behaviors
employed by individuals to reduce the intensity of experienced stress.
4. Identification and Intervention: Describe needed awareness of the symptoms of
chemical dependency, appropriate strategies for successful intervention, treatment, and
aftercare.
5. Re-Entry into the Workplace: Broadly describes components of successfully returning to
anesthesia practice. These components include frameworks for returning to
administrative, academic or clinical anesthesia practice, strategies to reduce the
likelihood of relapse, and elements of lifestyle adaptation that lead to a healthy balance
of professional work and physical, emotional, and spiritual health.
Clinical Hours – Clinical hours include time spent in the actual administration of anesthesia
(i.e., anesthesia time) and other time spent in the clinical area. Examples of other clinical time
would include in-house call, preanesthesia assessment, postanesthetic assessment, patient
preparation, OR preparation, and time spent participating in clinical rounds. Total clinical hours
are inclusive of total hours of anesthesia time; therefore, this number must be equal to or
greater than the total number of hours of anesthesia time.
Clinical Supervision – Clinical oversight of graduate students in the clinical area must not
exceed 1) two graduate students to one CRNA, or 2) two graduate students to one
anesthesiologist, if no CRNA is involved. There may be extenuating circumstances where
supervision ratios may be exceeded for brief periods of time (e.g., life threatening situations);
however, the program must demonstrate that this is a rare situation for which contingency
plans are in place (e.g., additional CRNA or anesthesiologist called in, hospital diverts
emergency cases to maximize patient safety).
Commonly Accepted National Standards – Commonly accepted national standards are
standards that are generally recognized as determining the quality of similar degrees by the
larger community of higher education in the United States.
Counting Clinical Experiences – Students can only take credit for a case where they personally
provide anesthesia for critical portions of the case. A student may only count a procedure (e.g.,
CVCL placement, regional block, etc.) that he or she actually performs. Students cannot take
credit for an anesthetic case if they are not personally involved with the management of the
anesthetic, or only observe another anesthesia provider manage a patient’s anesthetic care.
Two learners should not be assigned to the same case, except when the case provides learning
opportunities for two students and two anesthesia providers are necessary due to the acuity of
the case. The program will need to justify any deviation from this requirement.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 30
Credentialed Expert – An individual awarded a certificate, letter or other testimonial to practice
a skill in an institution is a credentialed expert. The credential must attest to the bearer’s right
and authority to provide services in the area of specialization for which she or he has been
trained. Examples are: a pulmonologist who is an expert in airway management; an emergency
room physician authorized by an anesthesia department to assume responsibility for airway
management; or a neonatologist who is an expert in airway management.
Critical Care Experience - Critical care experience must be obtained in a critical care area within
the United States, its territories or a U.S. military hospital outside of the United States. Dduring this
experience, which the registered professional nurse is to have has developed has had the
opportunity to develop critical decision making and psychomotor skills, competency in patient
assessment, and the ability to use and interpret advanced monitoring techniques.
A critical care area is defined as one where, on a daily basis, the registered professional nurse
manages invasive hemodynamic monitors (such as pulmonary artery catheter; CVP; arterial),
cardiac assist devices, mechanical ventilation, and vasoactive drips (such as norepinephrine;
epinephrine; dobutamine; nicardipine; nitroglycerine). The critical care areas include the
following: Surgical Intensive Care, Cardiothoracic Intensive Care, Coronary Intensive Care,
Medical Intensive Care, and Pediatric or Neonatal Intensive Care. Those who have experiences
in other areas may be considered provided they can demonstrate competence with invasive
monitoring, ventilators, and critical care pharmacology.
Culturally Competent – Cultural competency is demonstrated by effectively utilizing various
approaches in assessing, planning, implementing, and administering anesthesia care for
patients based on culturally relevant information.
Demonstration of Clinical Competency: The academic environment must provide substantial
access to practice experts in order for students to learn. As the competencies needed to
practice are rapidly changing, students must have access to instructors who possess clinical
content knowledge and create a learning environment that is characterized by a culture of
inquiry and practice scholarship that exemplifies rapid translation of new knowledge into
practice, and utilizes evaluation of practice-based models of care.
Clinical competence may be demonstrated by an instructor's involvement in one or more of the
following:
· Current clinical practice
· Research in clinical area
· Education in the clinical area
· Utilization of evidence based practice in instruction
· Participation in continuous professional development program
· Consultation with clinical experts
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 31
Experientially Qualified – Program Administrators must possess: a) a minimum of four years
clinical experience as a CRNA; b) graduate preparation in the basic and clinical sciences relevant
to nurse anesthesia practice, teaching and learning, and curriculum development and
implementation; c) current knowledge of CRNA practice and related professional issues; and d)
current knowledge of institutional and programmatic accreditation requirements for nurse
anesthesia educational programs.
Assistant Program Administrators must possess: a) a minimum of two years clinical experience
as a CRNA; b) graduate preparation in the basic and clinical sciences relevant to nurse
anesthesia practice, teaching and learning, and curriculum development and implementation;
c) current knowledge of CRNA practice and related professional issues; and d) current
knowledge of institutional and programmatic accreditation requirements for nurse anesthesia
educational programs.
Formal instruction in curriculum, evaluation and instruction - Formal instruction in curriculum,
evaluation and instruction includes completed educational content evidenced on a transcript
from an accredited institution of higher education, an AANA approved continuing education
(CE) program, or a CE program approved by another nationally recognized professional
approval organization.
Full Time Program Administrator – A full time program administrator is a CRNA who by title
and function maintains no less than a 0.8 FTE position directing the organizational
administration of a nurse anesthesia program; providing leadership and oversight of all aspects
of the educational program including, but not limited to, governance, didactic and clinical
curriculum, recruitment, and evaluation. The workload may include a reasonable teaching
commitment. Engagement in direct patient care activities, including supervising nurse
anesthesia student clinical performance, does not qualify as meeting organizational
administrative duties.
Institutional Accreditor – The institution where a degree is earned must be accredited by an
agency that is recognized by the U.S. Secretary of Education as a reliable authority for the
quality of training offered.
Nondiscriminatory Practice – Nondiscriminatory practice is the practice of treating all
individuals, including applicants, without regard to race, color, national origin, gender, marital
status, sexual orientation, religion, age or disability, consistent with law. Although an applicant
should not be required to provide information regarding any protected characteristics, he or
she can provide such information on a voluntary basis. An applicant may be asked if he or she
can perform the essential tasks or functions of a nurse anesthetist. without regard to race,
color, national origin, gender, religion, age, marital status, physical or mental handicap or
disability, sexual orientation, or any legally protected factor. Although an applicant should not
be required to provide discriminating information, he or she can provide such information on a
voluntary basis.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 32
According to federal law, an applicant may be asked if he or she can perform the essential tasks
or functions of an anesthetist, as long as all other applicants are asked the same question.
(Reference Title VII of the Civil Rights Act of 1964 and the Americans With Disabilities Act.)
Pain Management, Acute – Acute pain management involves the treatment of pain of recent
onset arising from a discrete cause, e.g., post operative pain. Acute pain may result from both
surgical and nonsurgical origins. The experience of acute pain can initiate a cascade of
emotional, physical, and/or social reactions.
Pain Management, Chronic – Chronic pain management involves the treatment of persistent
pain or discomfort that continues for an extended period of time [usually involving durations
greater than 3 to 6 months]. Chronic pain may result from both surgical and nonsurgical
origins. Some chronic conditions cause pain that may come and go for months or years or that
may cause acute increases in the pain level. Persistent pain in certain circumstances becomes a
disease with complex causal interactions of biological and psychological factors and not just a
symptom.
Pain Management Encounters – Pain management encounters are individual one-on-one
patient interactions for the express purpose of intervening in an acute pain episode or a chronic
pain condition. Pain management encounters must include a patient assessment prior to
initiating a therapeutic action. Pain management encounters include, but are not limited to,
the following:
1. Initiation of epidural or intrathecal analgesia.
2. Facilitation of initiation of patient controlled analgesia.
3. Initiation of regional analgesia techniques for post operative pain or other non-surgical
acute pain conditions, including but not limited to plexus blocks, local anesthetic
infiltration of incisions, intercostal blocks, etc.
4. Adjustment of drugs delivered, rates of infusion, concentration or dose parameters for
an existing patient controlled analgesia or patient controlled epidural analgesia.
5. Pharmacologic management of an acute pain condition in PACU.
6. Trigger point injections.
7. Electrical nerve stimulation.
The administration of intravenous analgesics as an adjunct to a general or regional anesthesia
technique does not constitute a pain management encounter for purposes of meeting minimal
COA required clinical experiences. The administration of regional anesthesia as the primary
anesthetic technique for a surgical procedure does not constitute an acute pain management
encounter.
Privilege to Practice – Privilege to practice is the authority to practice nursing in any compact
state that is not the state of residency. Additional license is not granted for this authority.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 33
Professional Role Development – Curricular content geared toward development as a
professional nurse anesthetist includes but is not limited to the history of nurse anesthesia,
standards of practice, professional ethics, regulation of practice (governmental and non-
governmental), legal aspects of practice, the business of anesthesia and practice management,
anesthesia reimbursement methodologies and payment policies, chemical dependency and
wellness, as well as the structure and function of the state, national, and international nurse
anesthesia organizations.
Protected Time – While the definition of protected time may vary somewhat, the intent is to
allow for reasonable balance between personal wellness and professional responsibilities. The
institution shall summarize expected faculty efforts for all activities including administration,
teaching, research, clinical, and other activities. Other activities include, but are not limited to,
those related to maintaining professional competence, scholarly pursuits, and professional
advancement. The total hours of faculty commitment must provide ample time for the faculty
member to maintain healthy work-life balance.
Public Member – A public member is someone who ensures that consumer concerns, public
and private, are formally represented and who curbs any tendency to put program priorities
before public interest. Such members should be selected at large, and they cannot be current
or former members of the healthcare profession or current or former employees of the
institution that is conducting the program. This also excludes anyone who might be perceived
to have divided loyalties or potential conflicts of interest, such as a relative of an employee or
former employee.
Published Outcomes – A program must publish accurate data and information to the public on
its performance. The data must demonstrate the degree to which it has achieved its purpose
and objectives. Publications can be in various formats but must include posting the information
on a website that is linked to the Council’s List of Recognized Programs.
Radiology – Didactic curricular content includes the fundamentals of radiologic principles and
various techniques; topographic anatomy; contrast agents; radiation safety; basic evaluation of
normal and abnormal radiographs of the chest, abdomen, and spine; evaluation of proper
positioning of various tubes (e.g., endotracheal tubes, chest tubes) and lines (e.g., central
venous catheters); and proper techniques of safe fluoroscopic equipment use.
Reasonable Time Commitment – A reasonable number of hours to ensure patient safety and
promote effective student learning should not exceed 64 hours per week. This time
commitment includes the sum of the hours time spent in class and all in clinical hours (see
Glossary, “Clinical Hours”) (including in house call), averaged over four weeks. StudentsThis
must have include a 10 hour rest period between scheduled clinical duty periods (i.e. assigned
continuous clinical hours shifts. Students who choose to work as a registered nurse in addition
to their responsibilities in the nurse anesthesia program must ensure that their work as an RN,
when combined with nurse anesthesia student time commitment, does not exceed the 64 hour
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 34
time commitment. At no time may a student provide direct patient care for a period longer
than 16 continuous hours.
Scholarly Work - The doctoral program culminates with the completion of a scholarly work that
demonstrates the ability to translate research findings into practice. This is an opportunity for
the student to prepare a substantial final written work product, applicable to nurse anesthesia
practice, that reflects the breadth of skills and knowledge the student has gained throughout
the program of study. The final written work product may be in the form of a manuscript
submitted for publication, a poster presented at a national meeting, design of innovative
clinical practice model, or other effective means of dissemination. The structure and process of
the scholarly work will vary according to the requirements of the governing institution, and
conform to accepted educational standards at the practice doctoral level.
Simulated Clinical Experiences – Simulated clinical experiences are learning experiences
involving the imitation or representation of clinical activities that are designed for competency
attainment, competency assessment, or competency maintenance. Simulation involves a wide
range of options including, but not limited to standardized patients, web-based simulation,
computer-based simulation, manikin-based technologies ranging from low- to high-fidelity, task
trainers, and holodecks. These clinical learning experiences are intended to help bridge didactic
learning with safe and effective patient care delivery.
Student Services - Student services consist of assistance offered to students such as financial
aid, health services, insurance, placement services, and counseling.
Title IV Eligibility - Title IV Higher Education Act (HEA) federal programs administered by the
U.S. Department of Education have a requirement for institutions or programs participating in
federally funded programs to be accredited by an institutional accreditor recognized by the U.S.
Secretary of Education. Examples of federal programs where accreditation provides a federal
link to funding are Direct Loans, Student Aid Programs (Stafford, PLUS and consolidation loans)
and Federal Perkins Loans.
Unshared governance - An unshared governance is a formal arrangement in which two or
more organizations or institutions are controlled by separate administrative authorities.
Written affiliation agreements are necessary between entities that participate in an unshared
governance arrangement.
Standards for Accreditation of Nurse Anesthesia Programs (Practice Doctorate) Draft 1 (Revised) Page 35
Standards Revision Task Force
Dr. Rebecca Gombkoto, Chair
Dr. Betty Horton, Consultant
Dr. Denise Martin-Sheridan
Dr. James Walker
Ms. Mary Jean Yablonky
Dr. Francis Gerbasi, Staff
Ms. Kara Chlebek, Staff